HIV infection, due to the immunosuppressant that leads, nowadays constitutes an aggravating factor of endemic tuberculosis. Tuberculosis remains a huge burden to human health, even in the early 21st century. The situation is deteriorating in many countries, particularly because of the synergy with t...he HIV epidemic and the emergence of multidrug-resistant (MDR) and extensively drug resistant (XDR) tuberculosis. The urgent development of new tools that can improve the diagnosis, prevention and/or treatment of tuberculosis and other major mycobacterium diseases depends largely on the progress of basic and applied research. Faced with this situation, there is an urgent need for effective strategies and actions to permanently solve the problem of this endemic disease whose impact is too negative on people’s lives.
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Malaria is a prevalent cause of febrile illnesses in areas with high transmission, and its clinical presentation overlaps with initial signs of Ebola disease. For this reason, the effectiveness of the Ebola response in Guinea, Liberia and Sierra Leone can be optimized through the deployment of targe...ted measures to reduce the number of fever cases due to malaria
WHO recommends specific adaptations in the diagnosis of malaria and in LLIN distribution in countries heavily affected by the Ebola outbreak and mass drug administration using artemisinin-based combination therapies (ACTs) in areas where transmission of both Ebola and malaria is high and access to malaria treatment is very low.
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Background: The human helminth infections include ascariasis, trichuriasis, hookworm infections, schistosomiasis, lymphatic filariasis (LF) and onchocerciasis. It is estimated that almost 2 billion people worldwide are infected with helminths. Whilst the WHO treatment guidelines for helminth infecti...ons are mostly aimed at controlling morbidity, there has been a recent shift with some countries moving towards goals of disease elimination through mass drug administration, especially for LF and onchocerciasis. However, as prevalence is driven lower, treating entire populations may no longer be the most efficient or cost-effective strategy. Instead, it may be beneficial to identify individuals or demographic groups who are persistently infected, often termed as being “predisposed” to infection, and target treatment at them.
Methods: The authors searched Embase, MEDLINE, Global Health, and Web of Science for all English language, humanbased papers investigating predisposition to helminth infections published up to October 31st, 2017. The varying definitions used to describe predisposition, and the statistical tests used to determine its presence, are summarised. Evidence for predisposition is presented, stratified by helminth species, and risk factors for predisposition to infection are identified and discussed.
Results: In total, 43 papers were identified, summarising results from 34 different studies in 23 countries. Consistent evidence of predisposition to infection with certain species of human helminth was identified. Children were regularly found to experience greater predisposition to Ascaris lumbricoides, Schistosoma mansoni and S. haematobium than adults. Females were found to be more predisposed to A. lumbricoides infection than were males. Household clustering of infection was identified for A. lumbricoides, T. trichiura and S. japonicum. Ascaris lumbricoides and T. trichiura also showed evidence of familial predisposition. Whilst strong evidence for predisposition to hookworm infection was identified, findings with regards to which groups were affected were considerably more varied than for other helminth species.
Conclusion: This review has found consistent evidence of predisposition to heavy (and light) infection for certain human helminth species. However, further research is needed to identify reasons for the reported differences between demographic groups. Molecular epidemiological methods associated with whole genome sequencing to determine ‘who infects whom’ may shed more light on the factors generating predisposition.
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In South and Central America, lymphatic filariasis (LF) is caused by Wuchereria bancrofti, which is transmitted by Culex quinquefasciatus, the only vector species in this region. Of the seven countries considered endemic for LF in the Americas in the last decade, Costa Rica, Suriname and Trinidad a...nd Tobago were removed from the World Health Organization list in 2011. The remaining countries, Brazil, Dominican Republic, Guyana and Haiti, have achieved important progress in recent years. Brazil was the first country in the Americas to stop mass drug administration (MDA) and to establish post-MDA surveillance. Dominican Republic stopped MDA in all LF-endemic foci: La Ciénaga and Southwest passed the third Transmission Assessment Survey (TAS) and the Eastern focus passed TAS-1 in 2018. Haiti passed the TAS and interrupted transmission in >80% of endemic communes, achieving effective drug coverage. Guyana implemented effective coverage in MDAs in 2017 and 2018 and in 2019 scaled up the treatment for 100% of the geographical region, introducing ivermectin in the MDA in order to achieve LF elimination by the year 2026. The Americas region is on its way to eliminating LF transmission. However, efforts should be made to improve morbidity management to prevent disability of the already affected populations.
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The larval stage of the parasite Taenia solium can encyst in the central nervous system causing neurocysticercosis, which is the main cause of acquired epilepsy in the countries in which the parasite is endemic. Endemic areas are those with the presence (or likely presence) of the full life cycle of... Taenia solium. The parasite is most prevalent in poor and vulnerable communities in which pigs roam free, open defecation is practiced, basic sanitation is deficient, and health education is absent or limited. Several tools are available for the control of Taenia solium. Preventive chemotherapy for Taenia solium taeniasis, which is directed at the adult tapeworm, is one of them. Other tools focus on pig management, pig vaccination and treatment, sanitation and hygiene, and community education. Three potential drugs—niclosamide, praziquantel, and albendazole—have been considered for use for preventive chemotherapy in Taenia solium taeniasis control programs through mass drug administration or targeted chemotherapy. In this Guideline, we provide recommendations for preventive chemotherapy in Taenia solium-endemic areas using niclosamide, praziquantel, or albendazole, including at which dose and in which population groups.
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The Sustainable Development Goals (SDGs) aim to transform our world. They are a call to action to end poverty and inequality, protect the planet, and ensure that all people enjoy health, justice and prosperity. It is critical that no one is left behind. In 2015, all the countries in the United... Nations adopted the 2030 Agenda for Sustainable Development. It sets out 17 Goals, which include 169 targets. These wide-ranging and ambitious Goals interconnect. SDG 3 is to ensure healthy lives and promote well-being for all at all ages. It has 13 targets measured through 26 indicators. However, a person’s health and well-being are affected not only by disease and treatment, but also by social and economic factors such as housing, poverty and education. Health targets can therefore also be found across the other SDGs. This fact sheet shows how alcohol consumption undermines commitments to achieve 13 of the 17 SDGs, impacting on a range of health-related indicators, such as child health, infectious diseases and road injuries as well as much broader range of indicators related to economic and social development, environment and equality. The inclusion of a specific target on harmful use of alcohol (SDG 3.5: strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol) into the SDGs demonstrates the key role of alcohol within the global development agenda. The factsheet highlights positive examples of Member States’ experiences. It provides a short overview of the most cost-effective and feasible policy recommendations to reduce alcohol consumption and alcohol-attributable burden in the WHO European Region, in line with the European Action Plan to Reduce the Harmful Use of Alcohol. It also suggests some important resources for Member States. This factsheet was launched as part of the European Awareness Week on Alcohol Related Harm 2020.
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Non-communicable diseases (NCDs) pose a substantial threat to many health systems, especially in low-income and middle-income countries (LMICs) where they are already overstretched. In the past few decades, deaths from NCDs in LMICs have spiked, whereas numbers in high-income countries have stabilis...ed. Worryingly, a large proportion of deaths from NCDs (29%) in LMICs occur among people younger than 60 years compared with the proportion in high-income countries (13%). This finding has been attributed to poor access to effective and equitable health-care services in most LMICs. The threat of NCDs in LMICs was recognised by the UN 2011 High-Level Meeting, and is now featured in Sustainable Development Goal 3 in the form of reducing premature mortality from NCDs by one-third before 2030. Cardiovascular diseases (CVDs) are the leading cause of deaths from NCDs (ie, 48% of all NCDs deaths). Therefore, substantial reductions in CVDs will have a major impact on reducing the overall burden of NCDs globally. The good news is that most CVDs can be prevented by addressing the key underlying behavioural risk factors, such as physical inactivity, unhealthy diet, tobacco use, and harmful use of alcohol, through population-wide approaches. Among individuals with or at high risk of CVD, early detection and effective management with appropriate counselling and medicines can reduce cardiovascular deaths substantially.
The importance of effective treatment for CVD has been recognised in the Global NCD Action Plan 2013–20, for which one of the nine global targets is that at least 50% of eligible individuals should receive drug therapy and counselling to prevent heart attacks and strokes by 2025.5 Although admirable, this is a hard target to achieve given that secondary prevention strategies in LMICs are often unaffordable or unavailable.
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Technical information note. Ensuring an uninterrupted supply of quality-assured, affordable anti-TB
drugs and diagnostics to the world
Bulletin of the World Health Organization, 2001, 79 (4)
Lymphatic filariasis is a vector-borne neglected tropical disease that causes damage of the lymphatic system and can lead to lymphoedema (elephantiasis) and hydrocele in infected individuals. The global baseline estimate of persons affected by lymphatic filariasis is 25 million men with hydrocele an...d over 15 million people with lymphoedema. At least 36 million persons remain with these chronic disease manifestations. The disease is endemic in 72 countries. In 2016, an estimated total population of 856 million were living in areas with ongoing transmission of the causative filarial parasites and requiring mass drug administration (MDA). Lymphatic filariasis disfigures and disables, and often leads to stigmatization and poverty. Hundreds of millions of dollars are lost annually due to reduced productivity of affected patients. WHO has ranked the disease as one of the world’s leading causes of permanent and long-term disability.
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This third booklet of the World Drug Report 2022 has a dual focus: opioids and cannabis.
The first chapter of the booklet provides an overview of opioids as a group of substances and their patterns of non-medical use at the global level. It also reviews the latest trends in the global supply of opi...ates and synthetic opioids and the availability of pharmaceutical opioids for medical consumption. Issues specific to regional patterns and trends in opioid markets are also analysed, including the opioid crisis in North America and in Africa and the Middle East. The chapter also includes a discussion of the potential impact, in the region and worldwide, of changes in opium poppy cultivation and opium production in Afghanistan. reireg
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Accessed online January 2019, publication date unknown.